A Chiari (pronounced “key-AR-ee”) malformation is when part of the brain extends outside the skull into the spinal canal (the upper part of the spinal cord). Children with milder forms may not have any symptoms, but those with more severe forms may have a wide range of symptoms. A Chiari malformation can be congenital (present at birth) or acquired (occur over time).

At Nemours, our goals in treating a Chiari malformation are to relieve any symptoms, reduce pressure on the brain, and improve your child’s quality of life.

Learn More About Chiari Malformation  

We treat all of the different types of Chiari malformation in children. That includes Chiari malformation type I (the most common form, which is milder and may not require treatment) as well as Chiari malformation type II (sometimes called “classic Chiari malformation” or “Arnold Chiari malformation,” which usually only occurs in kids with spina bifida). We also treat the more rare Chiari malformation types III and IV.

Our pediatric neurosurgeons, neurologists and neuroradiologists (doctors who specialize in imaging of the brain) are experts at recognizing the different signs and symptoms of Chiari malformation in children. We work together to provide a range of diagnostic and treatment options for kids with Chiari malformation, which may vary depending on the location you visit and the doctor your child sees:

• radiology (medical imaging) tests like a CT scan, MRI or X-ray
• ophthalmology (eye) exam to evaluate potential problems in and around the eyes
• otolaryngology exam to examine balance and potential ear, nose and throat disorders
• sleep study to look at sleep disorders like sleep apnea
• urology testing including urodynamic testing, which looks at any problems with storing and releasing urine (pee)
• medications and/or physical therapy to address symptoms like headaches, neck pain or balance problems
• neurosurgery if needed, like a common procedure called “posterior fossa decompression” to relieve symptoms and reduce the pressure on the brain and spinal cord

We may also recommend limiting certain activities that may make symptoms worse. Fortunately, symptoms usually don't get worse and surgery isn't necessary for kids with milder forms. And most children with less severe types of Chiari malformations do very well and grow up to be active kids and independent adults. For children with no symptoms, we take a conservative approach. It’s called “watchful waiting,” which really means no treatment is necessary and we schedule regular check-ups to monitor your child’s condition. 

Using proven treatments that have the least amount of side effects, we’ll first address your child’s immediate needs and then develop a plan for further care. If your child needs surgery, our highly skilled neurosurgeons are experienced in performing endoscopic (minimally invasive) surgery for smaller incisions and faster healing. 

We also offer:

• world-class facilities featuring the most advanced diagnostic techniques and equipment available
• customized treatment plans based on research and commonly accepted best care practices
• fully equipped neurosurgery operating rooms
• innovative surgical techniques that minimize surgery risks, recovery time and pain

Whether your child has Chiari malformation type I (also called “Chiari I malformation”) or a more rare form, our neurosurgeons will take the time to listen to your concerns and give your child personal, thorough, medical and surgical care.

Regional Chiari Malformation Highlights 

Services, programs and care teams differ at each location. Call for details.